Nepal pictures, history, people, facts

I have been on Zoloft for 6 weeks and am getting ready for a check up with our family doc.  I was told I had a classic case book example of depression.. however one of my co-workers who I admire and respect is bi-polar and spoke with me about  the possibilities of this also being true for me.  I have extreme mood swings.. low one hour and then a silly giddy kind of high the next. Yes, i am extremely creative and the lack of sleep thing followed by wanting to sleep all day is also true.. i am lucky, I have the support of my bosses at work, and my family.. What should I look for as in symptoms of being bi-polar or should I just ask the doc to up my dose of Zoloft ( currently i am on 50 a day). I also have the names of trusted friends therapist that I plan to speak with in the very near future,  i am 34, female , married with 2 children and work full time outside the home as a trainer for new hires for a superstore.    Thank you for your time... anyone wishing to may reply to my home email. Warm Wishes, Lisa

with our family doc.  I was told I had a classic case book example of depression.. however one of my co-workers who I admire and respect is bi-polar and spoke with me about  the possibilities of this also being true for me.  I have extreme mood swings.. low one hour and then a silly giddy kind of high the next. Yes, i am extremely creative and the lack of sleep thing followed by wanting to sleep all day is also true.. i am lucky, I have the support of my bosses at work, and my family.. What should I look for as in symptoms of being bi-polar or should I just ask the doc to up my dose of Zoloft ( currently i am on 50 a day). I also have the names of trusted friends therapist that I plan to speak with in the very near future,  i am 34, female , married with 2 children and work full time outside the home as a trainer for new hires for a superstore.    Thank you for your time... anyone wishing to may reply to my home email. I have enclosed info on BP Disorder for you. Peace, Lynda =================================== http://www.cmhc.com/disorders/sx20.htm Bipolar I Disorder actually is a number of separate diagnoses, depending upon the type of mood most recently experienced. Bipolar I Disorder, Single Manic Episode *       Presence of only one Manic Episode and no past Major Depressive Episodes. Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms. Bipolar I Disorder, Most Recent Episode Manic *       Currently (or most recently) in a Manic Episode. *       There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode. Bipolar I Disorder, Most Recent Episode Mixed *       Currently (or most recently) in a Mixed Episode. *       There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode. Bipolar II Disorder *       Presence (or history) of one or more Major Depressive Episodes and at least one Hypomanic Episode. Additionally, there has never been a Manic Episode or a Mixed Episode. References: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association. National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3679 (1995) Bipolar III BP III is not currently an official designation since it is not yet in the DSM IV. Perhaps it will be in DSM V? But some pdocs are using it to further subdivide the BP II category. Frequently a BP condition is diagnosed only when an antidepressant induces hypomania. These patients are usually being treated for clinical depression or unipolar depression. Here is an interesting page: http://www.mhsource.com/bipolar/bp9708explore.html ====================================   Depressive personality refers to *long-standing* depressive character traits, not to feeling depressed or blue for a day or two. Here are the current diagnostic criteria (DSM-IV, American Psychiatric Press 1994) for Dysthymic Disorder: 300.4 Dysthymic Disorder A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year. B. Presence, while depressed, of two (or more) of the following: (1) poor appetite or overeating (2) insomnia or hypersomnia (3) low energy or fatigue (4) low self-esteem (5) poor concentration or difficulty making decisions (6) feelings of hopelessness C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time. D. No Major Depressive Episode has been present during the first 2 years of the disturbance (1 year for children and adolescents); i.e., the disturbance is not better accounted for by chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission. Note: There may have been a previous Major Depressive Episode provided there was a full remission (no significant signs or symptoms for 2 months) before development of the Dysthymic Disorder. In addition, after the initial 2 years (1 year in children or adolescents) of Dysthymic Disorder, there may be superimposed Major Depressive Episodes, in which case both Dysthymic Disorder and Major Depressive Disorder may be diagnosed when the criteria are met for a Major Depressive Episode. E. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode, and criteria have never been met for Cyclothymic Disorder. F. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder. G. The symptoms are not due to the direct physiological effects of a substance or a general medical condition (e.g., hypothyroidism). H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Depressive Personality Disorder is currently being researched for possible inclusion in the DSM (say, in DSM-V). I know that John Gunderson & colleagues at McLean did a study in which they found it to be a valid diagnostic category. Here are the research criteria (also from DSM-IV): Depressive Personality Disorder A. A pervasive pattern of depressive cognitions and behaviors beginning by early adulthood and present in a variety of contextx, as indicated by five (or more) of the following: (1) usual mood is dominated by dejection, gloominess, cheerlessness, joylessness, unhappiness (2) self-concept centers around beliefs of inadequacy, worthlessness, and low self-esteem (3) is critical, blaming, and derogatory toward self (4) is brooding and given to worry (5) is negativistic, critical, and judgmental toward others (6) is pessimistic (7) is prone to feeling guilty or remorseful B. Does not occur exclusively during Major Depressive Episodes and is not better accounted for by Dysthymic Disorder. Because this is classed as a personality disorder, an individual must also fulfill the following criteria in order to be diagnosed with Depressive Personality Disorder: A. An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture.  This pattern is manifested in two or more of the following ways: (1) cognition (ways of perceiving and interpreting self, other people, and events) (2) affectivity (the range, intensity, lability, and appropriateness of emotional response) (3) interpersonal functioning (4) impulse control B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. C. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood. E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder. F. The enduring pattern is not due to the direct physiological effects of a substance or a general medical condition (e.g., head trauma). As you can see, it's rather hard to say whether there even *is* a difference, and some authors have argued that there is not. Here are some references on both sides of the issue: Ryder AG, Bagby RM. Diagnostic viability of depressive personality disorder: theoretical and conceptual issues. J Personal Disord 1999 Summer;13(2):99-117; discussion 118-27, 152-6. Huprich SK. Depressive personality disorder: theoretical issues, clinical findings, and future research questions. Clin Psychol Rev. 1998 Aug;18(5):477-500. Phillips KA, Gunderson JG, Triebwasser J, Kimble CR, Faedda G, Lyoo IK, Renn J. Reliability and validity of depressive personality disorder. Am J Psychiatry. 1998 Aug;155(8):1044-8. [full text is at http://ajp.psychiatryonline.org/cgi/content/full/155/8/1044] Hartlage S, Arduino K, Alloy LB. Depressive personality characteristics: state dependent concomitants of depressive disorder and traits independent of current depression. J Abnorm Psychol. 1998 May;107(2):349-54. Klein DN, Shih JH. Depressive personality: associations with DSM-III-R mood and personality disorders and negative and positive affectivity, 30-month stability, and prediction of course of Axis I depressive disorders. J Abnorm Psychol. 1998 May;107(2):319-27. Lyoo K, Gunderson JG, Phillips KA. Personality dimensions associated with depressive personality disorder. J Personal Disord. 1998 Spring;12(1):46-55. Huprich SK, Margrett J, Barthelemy KJ, Fine MA. The Depressive Personality Disorder Inventory: an initial examination of its psychometric properties. J Clin Psychol. 1996 Mar;52(2):153-9. Keller MB, Hanks DL, Klein DN. Summary of the DSM-IV mood disorders field trial and issue overview. Psychiatr Clin North Am. 1996 Mar;19(1):1-28. Hirschfeld RM. Major depression, dysthymia and depressive personality disorder. Br J Psychiatry Suppl. 1994 Dec;(26):23-30. Gunderson JG, Phillips KA, Triebwasser J, Hirschfeld RM. The Diagnostic Interview for Depressive Personality. Am J Psychiatry. 1994 Sep;151(9):1300-4. Hirschfeld RM, Holzer CE 3rd. Depressive personality disorder: clinical implications. J Clin Psychiatry. 1994 Apr;55 Suppl:10-7. See also the book _Dysthymia and the Spectrum of Chronic Depressions_ (Akiskal and Cassano, eds., The Guilford Press 1997), which has chapters on dysthymia, residual depression, depressive personality, and neurotic depression, among others. ==================================== James MacLachlan wrote in
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with our family doc.  I was told I had a classic case book example of depression.. however one of my co-workers who I admire and respect is bi-polar and spoke with me about  the possibilities of this also being true for me.  I have extreme mood swings.. low one hour and then a silly giddy kind of high the next. Yes, i am extremely creative and the lack of sleep thing followed by wanting to sleep all day is also true.. i am lucky, I have the support of my bosses at work, and my family.. What should I look for as in symptoms of being bi-polar or should I just ask the doc to up my dose of Zoloft ( currently i am on 50 a day). I also have the names of trusted friends therapist that I plan to speak with in the very near future,  i am 34, female , married with 2 children and work full time outside the home as a trainer for new hires for a superstore.    Thank you for your time... anyone wishing to may reply to my home email. I have enclosed info on BP Disorder for you. Peace, Lynda =================================== http://www.cmhc.com/disorders/sx20.htm Bipolar I Disorder actually is a number of separate diagnoses, depending upon the type of mood most recently experienced. Bipolar I Disorder, Single Manic Episode *       Presence of only one Manic Episode and no past Major Depressive Episodes. Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms. Bipolar I Disorder, Most Recent Episode Manic *       Currently (or most recently) in a Manic Episode. *       There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode. Bipolar I Disorder, Most Recent Episode Mixed *       Currently (or most recently) in a Mixed Episode. *       There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode. Bipolar II Disorder *       Presence (or history) of one or more Major Depressive Episodes and at least one Hypomanic Episode. Additionally, there has never been a Manic Episode or a Mixed Episode. References: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association. National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3679 (1995) Bipolar III BP III is not currently an official designation since it is not yet in the DSM IV. Perhaps it will be in DSM V? But some pdocs are using it to further subdivide the BP II category. Frequently a BP condition is diagnosed only when an antidepressant induces hypomania. These patients are usually being treated for clinical depression or unipolar depression. Here is an interesting page: http://www.mhsource.com/bipolar/bp9708explore.html ====================================   Depressive personality refers to *long-standing* depressive character traits, not to feeling depressed or blue for a day or two. Here are the current diagnostic criteria (DSM-IV, American Psychiatric Press 1994) for Dysthymic Disorder: 300.4 Dysthymic Disorder A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year. B. Presence, while depressed, of two (or more) of the following: (1) poor appetite or overeating (2) insomnia or hypersomnia (3) low energy or fatigue (4) low self-esteem (5) poor concentration or difficulty making decisions (6) feelings of hopelessness C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time. D. No Major Depressive Episode has been present during the first 2 years of the disturbance (1 year for children and adolescents); i.e., the disturbance is not better accounted for by chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission. Note: There may have been a previous Major Depressive Episode provided there was a full remission (no significant signs or symptoms for 2 months) before development of the Dysthymic Disorder. In addition, after the initial 2 years (1 year in children or adolescents) of Dysthymic Disorder, there may be superimposed Major Depressive Episodes, in which case both Dysthymic Disorder and Major Depressive Disorder may be diagnosed when the criteria are met for a Major Depressive Episode. E. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode, and criteria have never been met for Cyclothymic Disorder. F. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder. G. The symptoms are not due to the direct physiological effects of a substance or a general medical condition (e.g., hypothyroidism). H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Depressive Personality Disorder is currently being researched for possible inclusion in the DSM (say, in DSM-V). I know that John Gunderson & colleagues at McLean did a study in which they found it to be a valid diagnostic category. Here are the research criteria (also from DSM-IV): Depressive Personality Disorder A. A pervasive pattern of depressive cognitions and behaviors beginning by early adulthood and present in a variety of contextx, as indicated by five (or more) of the following: (1) usual mood is dominated by dejection, gloominess, cheerlessness, joylessness, unhappiness (2) self-concept centers around beliefs of inadequacy, worthlessness, and low self-esteem (3) is critical, blaming, and derogatory toward self (4) is brooding and given to worry (5) is negativistic, critical, and judgmental toward others (6) is pessimistic (7) is prone to feeling guilty or remorseful B. Does not occur exclusively during Major Depressive Episodes and is not better accounted for by Dysthymic Disorder. Because this is classed as a personality disorder, an individual must also fulfill the following criteria in order to be diagnosed with Depressive Personality Disorder: A. An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture.  This pattern is manifested in two or more of the following ways: (1) cognition (ways of perceiving and interpreting self, other people, and events) (2) affectivity (the range, intensity, lability, and appropriateness of emotional response) (3) interpersonal functioning (4) impulse control B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. C. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood. E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder. F. The enduring pattern is not due to the direct physiological effects of a substance or a general medical condition (e.g., head trauma). As you can see, it's rather hard to say whether there even *is* a difference, and some authors have argued that there is not. Here are some references on both sides of the issue: Ryder AG, Bagby RM. Diagnostic viability of depressive personality disorder: theoretical and conceptual issues. J Personal Disord 1999 Summer;13(2):99-117; discussion 118-27, 152-6. Huprich SK. Depressive personality disorder: theoretical issues, clinical findings, and future research questions. Clin Psychol Rev. 1998 Aug;18(5):477-500. Phillips KA, Gunderson JG, Triebwasser J, Kimble CR, Faedda G, Lyoo IK, Renn J. Reliability and validity of depressive personality disorder. Am J Psychiatry. 1998 Aug;155(8):1044-8. [full text is at http://ajp.psychiatryonline.org/cgi/content/full/155/8/1044] Hartlage S, Arduino K, Alloy LB. Depressive personality characteristics: state dependent concomitants of depressive disorder and traits independent of current depression. J Abnorm Psychol. 1998 May;107(2):349-54. Klein DN, Shih JH. Depressive personality: associations with DSM-III-R mood and personality disorders and negative and positive affectivity, 30-month stability, and prediction of course of Axis I depressive disorders. J Abnorm Psychol. 1998 May;107(2):319-27. Lyoo K, Gunderson JG, Phillips KA. Personality dimensions associated with depressive personality disorder. J Personal Disord. 1998 Spring;12(1):46-55. Huprich SK, Margrett J, Barthelemy KJ, Fine MA. The Depressive Personality Disorder Inventory: an initial examination of its psychometric properties. J Clin Psychol. 1996 Mar;52(2):153-9. Keller MB, Hanks DL, Klein DN. Summary of the DSM-IV mood disorders field trial and issue overview. Psychiatr Clin North Am. 1996 Mar;19(1):1-28. Hirschfeld RM. Major depression, dysthymia and depressive personality disorder. Br J Psychiatry Suppl. 1994 Dec;(26):23-30. Gunderson JG, Phillips KA, Triebwasser J, Hirschfeld RM. The Diagnostic Interview for Depressive Personality. Am J Psychiatry. 1994 Sep;151(9):1300-4. Hirschfeld RM, Holzer CE 3rd. Depressive personality disorder: clinical implications. J Clin Psychiatry. 1994 Apr;55 Suppl:10-7. See also the book _Dysthymia and the Spectrum of Chronic Depressions_ (Akiskal and Cassano, eds., The Guilford Press 1997), which has chapters on dysthymia, residual depression, depressive personality, and neurotic depression, among others. ==================================== - Ukryj cytowany tekst -- Poka? cytowany tekst -James MacLachlan wrote in message
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